Endometriosis & Pelvic pain

Thank you for contacting The Endometriosis and Pelvic Pain Clinic at Hunters Hill Medical Practice.

Below, you will find a link to a pre-consultation survey. We ask that you complete and return this to us at your earliest convenience. Your responses will be tabulated and forwarded to one of the GPs to better facilitate your consultation and plan. Your data will be treated confidentially with only those responsible for your care accessing it.

Please follow the link below to complete the survey

A few days after we receive your completed questionnaire, you will be contacted by our clinic nurse to arrange your first appointment with one of our GPs and answer any questions you may have.

If you have any questions or problems completing the survey, please call Hunters Hill Medical Practice on (02) 9817 2080 and ask to speak to The Endometriosis and Pelvic Pain Clinic nurse.

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Below is some further information about The Endometriosis and Pelvic Pain Clinic and some of the treatment pathways that are available to you.

What is Endometriosis?

Endometriosis is a condition where tissue similar to that of the innermost layer of the uterus (endometrium) grows in locations outside the uterus.

Symptoms vary from person to person and can include:

  • Period Pain (dysmenorrhoea) that is not relieved by pain medications such as paracetamol
  • Pelvic and abdominal pain outside of menstruation
  • Painful Urination
  • Abnormal bleeding including heavy bleeding, clotting, prolonged bleeding and premenstrual spotting
  • Lower back, thigh and/or leg pain
  • Intense pain that restricts your ability to take part in activities such as work, school or sporting activities.
  • Inability to get pregnant
  • Lethargy or extreme tiredness
  • Fertility issues

Treating endometriosis is not simply about cutting out (surgery) the offending areas. Comprehensive treatment aims to address your functional goals and often requires a team approach including: GPs (at the clinic and your usual GP), physiotherapist, dietitian, gynaecologist, psychologist, endocrinologist, ultrasound radiologist, pain specialist and others as needed.

What is Pelvic Pain?

Consistent pelvic pain is defined as pain in the area of the pelvis which is present on most days for more than 6 months. Pelvic pain may relate to any of the pelvic organs, including bowel, bladder or reproductive organs, as well as the pelvic muscles.

Pain is both a physical process arising from local nerve irritation but also a psychological process which involves our bodies sensitisation to pain and thus our perception of such pain.

Treating chronic pain thus requires multiple modalities such as diet, exercise, relaxation modalities, medications, physiotherapy, psychology and much more.

The Endometriosis and Pelvic Pain Clinic

In 2023, the Federal Government announced limited funding for the development of 20 clinics nationwide to facilitate care for women with Endometriosis and Pelvic Pain. The Hunters Hill Medical Practice Endometriosis and Pelvic Pain Clinic is one such clinic. We aim to use the funding for a combination of staff education, improved resourcing, patient awareness and some clinical services as part of a multidisciplinary clinic approach. This will help improve timely access to care and treatment for appropriate patients.

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The Clinic Approach

Completing your questionnaire prior to your initial consultation is essential. At your first appointment a full history will be taken/reviewed and your doctor will ask many questions about your symptoms, pain and lifestyle. You will likely have a physical examination and may also need to have an internal examination (please advise the doctor if you are not able to do this).
After your initial consultation with one of our GPs, a treatment and management plan will be created for you based on your goals and the doctor’s recommendations. We embrace a multi-disciplinary approach to treatment and your plan may include:

  • Gynaecological Ultrasound (If not previously done)
  • MRI scan (rare)
  • Medication for pain management
  • Hormone therapy
  • Dietitian
  • Specialists such as Gynaecologists, Pelvic Floor Physiotherapist, Exercise physiologist, Pain Psychologists, Counsellor, Urologist, or Colorectal Surgeon.

Empowered Relief

Every patient who attends the Endometriosis and Pelvic Pain Clinic will have FREE access to “Empowered Relief”, a 2-2.5 hour, evidence-based group online pain class run by a psychologist (Amanda Patterson). This session equips patients with pain management skills and has been shown to be equivalent to 6 one-hour cognitive behavioural therapy sessions. This session has measurable long term benefits with regards to pain intensity, pain anxiety, low mood, fatigue and sleep disturbance.

Dietetics

Every patient who attends the Endometriosis and Pelvic Pain Clinic will have FREE access to a 1-1.5hour session on diet education run by a dietitian (Tatiana Bedikian from Body Fusion). Endometriosis pain can affect and co-exist with irritable bowel symptoms, constipation, bloating etc. This session will give you practical dietary and nutrition advice for bowel-related symptoms commonly associated with Endometriosis and will include a question-and-answer session. A handout with all the information will be available for patients following each session.

Expected Costs

The practice is a private billing practice and for most patients some gaps apply.

For new patients, the gap for the first doctor consult (30 minutes) is about $110 with subsequent shorter consults incur a lower gap. The nursing case management, dietetics education (1-1.5 hours) and pain management course (2-2.5 hours) do not incur any fees.

Patients who already have an endometriosis diagnosis can still access the dietetics education (1-1.5 hours) and pain management course (2-2.5 hours) but will need a doctor’s consult beforehand to check suitability. Such consults are normally shorter (15 minutes) with a gap fee of about $70.

Patients who have a heath care card, a disability support pension or are of Aboriginal and Torres Strait Islander heritage are bulk billed. The only fee is $30 which acts as a non-refundable appointment confirmation fee to cover the cost of endometriosis education materials.

Other costs are likely to be incurred outside of our practice. We have no control over such costs. Some examples are included below:

  • Blood tests – most pathology providers bulk bill these
  • Deep Endometriosis Ultrasound – about $500 with no rebate; this is a specialised test that should only be done with specialised providers. This is different to the normal pelvic ultrasound.
  • Women’s Health Physiotherapy (about $150+; health fund rebates or care plans may apply; public waiting lists at some hospitals).
  • Psychologists (about $200+; may be able to have a mental health plan to help subsidise the fees).
  • Specialists such as gynaecologists, urologists, endocrinologists etc will have their own private fees, often with a Medicare rebate. The fees are likely to be higher if a procedure is performed.
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Your local GP

It is important to remember that The Endometriosis and Pelvic Pain Clinic works with your GP and does not replace your local GP. In fact, we expect to see most patients for about 3 months or less before transferring care back to their usual GP. Your own GP is connected to your local community and is likely to have known you for some time, they are best placed to manage your care long-term.

Aiming for the best possible outcome

Pelvic pain and endometriosis are chronic conditions where resolution may not be possible and functional outcomes are a better measure of success. We help you set health goals and advise you to achieve them.

Please help us to be best able to help you

Click here to complete the endometriosis clinic questionnaire.
Also please provide any blood tests, ultrasound results, specialist letters or related to help us prepare for your consult and avoid repetition. Please supply these electronically to the email below.

Our clinic nurse will assist you with making all the necessary appointments and will be your point of contact throughout your time as a patient of the clinic. We look forward to looking after you.

For any questions please email clinic@hhmp.com.au or call 9817 2080

Click option 3 or ask to speak to the nurse.

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